The VA's Phony Waiting Lists

VA Hospital

Photo courtesy of the Veteran's Administration

The VA's Phony Waiting Lists
| Published April 29, 2014 |

By Earl Perkins
Thursday Review contributor

At least 40 United States veterans have died awaiting appointments at the Phoenix Veterans Affairs Health Care system, with many being placed on a secret waiting list, according to a CNN investigation.

Also, internal VA documents show at least 19 deaths, including ones in Georgia, were "preventable deaths," and possibly 60 more patients are seriously ill because they didn't receive important tests in a timely fashion. The VA has refused to state where the events happened or if those responsible were disciplined. A retired VA doctor and several high-level sources revealed Phoenix VA managers designed an elaborate scheme which hid 1,400 to 1,600 sick veterans, forcing them to wait months to visit a doctor.

For six months now, CNN has been reporting on extended delays in health-care appointments to veterans nationwide, which eventually led to their deaths. However, the extensive reporting on the Phoenix case causes the earlier stories to pale in comparison.

An official (sham) list, which has been shared with Washington officials, shows the VA has provided timely patient appointments, while the hidden list shows wait times in excess of one year, according to Dr. Sam Foote, who recently retired after 24 years with the Phoenix VA system. Top management at the Arizona hospital condoned and defended the practice, according to internal e-mails.

"The scheme was deliberately put in place to avoid the VA's own internal rules," Foote said. "They developed the secret waiting list." VA guidelines require hospitals to provide care in a timely manner, usually 14 to 30 days, but evidence was shredded to hide the secret list of patients awaiting appointments and care. Officials at the VA were told to not make doctor appointments for veterans in the computer, according to Foote.

"They enter information into the computer and do a screen capture hard copy printout," Foote said. "They then do not save what was put into the computer so there's no record that you were ever here." The information was captured on a secret electronic list, while the information showing when vets actually started waiting for an appointment was destroyed.

"That hard copy, if you will, that has the patient demographic information is then taken and placed onto a secret electronic waiting list, and then the data that is on that paper is shredded," Foote said. "So the only record that you have ever been there requesting care was on that secret list. And they wouldn't take you off that secret list until you had an appointment time that was less than 14 days so it would give the appearance that they were improving greatly the waiting times, when in fact they were not."

This looks like a slam-dunk case if the accusations prove true, but just like anything else in the American legal system, we shall see. And Foote has been defending those he left behind.

"I feel very sorry for the people who work at the Phoenix VA," he said. "They're all frustrated. They're all upset. They all wish they could leave 'cause they know what they're doing is wrong. But they have families, they have mortgages and if they speak out or say anything to anybody about it, they will be fired and they know that."

Several high-level VA staff members confirmed Foote's statements and agreed the wait times reported to the Feds were incorrect.

"So then when they did that, they would report to Washington, 'Oh yeah. We're makin' our appointments within—within 10 days, within the 14-day frame,' when in reality it had been six, nine, in some cases 21 months," he said.

Navy veteran Thomas Breen, 71, was a proud Navy man when he sought help from the VA, not knowing he'd be placed on the secret list.

"We had noticed that he started to have bleeding in his urine," said Teddy Barnes-Breen, his son. "So I was like, 'Listen, we gotta get you to the doctor.' " Breen had blood in his urine and a history of cancer when he was rushed to the Phoenix VA emergency room by Teddy and his wife, Sally, on September 28, 2013. He was examined and told to await a call at home.

"They wrote on his chart that it was urgent," said Sally, her father-in-law's main caretaker. Breen's family showed a reporter his chart, pointing out the urgency as one week to see a primary care doctor, or at least a urologist. "And they sent him home," says Teddy, incredulously.

He was given an appointment with a rheumatologist to look at his prosthetic leg, and that was all. The phone never rang for his primary care appointment, although Sally called numerous times seeking help.

"Well, you know, we have other patients that are critical as well," Sally was told. "It's a seven-month waiting list. And you're gonna have to have patience."

Sally continually called from late September through November, but her persistence was no longer needed. Breen died November 30, with the death certificate stating Stage 4 bladder cancer as cause of death.

"They called me December 6. He's dead already."

Sally says the VA official told her, "We finally have that appointment. We have a primary for him.' I said, 'Really, you're a little too late, sweetheart.' "

And the suffering worsened for Breen as time passed, according to his daughter-in-law.

"At the end is when he suffered. He screamed. He cried," Sally said. "And that's somethin' I'd never seen him do before, was cry. Never. Never. He cried in the kitchen right here. 'Don't let me die.' "

Teddy added his father said: "Why is this happening to me? Why won't anybody help me?"

Foote cited Breen as an example of a vet who need an urgent-care appointment with a primary doctor, but instead was shunted onto the secret waiting list.

"They could just remove you from that list, and there's no record that you ever came to the VA and presented for care. ... It's pretty sad."

E-mails from July 2013 show that top management, including Phoenix VA Director Sharon Helman, was aware of the wait times, knew about the electronic off-the-books list and defended its use to its staff.

A Phoenix VA staffer raised red flags concerning the secret list and the government's insistence on praising its use.

"I have to say, I think it's unfair to call any of this a success when veterans are waiting six weeks on an electronic waiting list before they're called to schedule their first PCP (primary care physician) appointment," the e-mail states. "Sure, when their appointment is created, it can be 14 days out, but we're making them wait 6-20 weeks to create that appointment. That is unethical and a disservice to our veterans."

Last year and early this year Foote sent letters to officials at the VA Office of the Inspector General noting the electronic waiting list and that veterans died while awaiting appointments, which led IG inspectors to interview Foote and several others inside the Phoenix VA.

"This was a plan that involved the Pentad, which includes the director, the associate director, the assistant director, the chief of nursing, along with the medical chief of staff—in collaboration with the chief of H.A.S," Foote said.

Rep. Jeff Miller (FL), chairman of the U.S. House Veterans Affairs Committee in Washington, has taken an interest in the list while investigating delays in care at VA hospitals nationwide. He has demanded that all VA records concerning the allegations be preserved, pending a congressional investigation. In an April 9 hearing, Miller learned the undersecretary of health for the VA had no clue about the secret list's existence.

"It appears as though there could be as many as 40 veterans whose deaths could be related to delays in care. Were you made aware of these unofficial lists in any part of your look back?" Miller asked.

"Mr. Chairman, I was not," replied Dr. Thomas Lynch, assistant deputy undersecretary, Veterans Health Administration.

Meanwhile, family and friends of Breen and the other vets await the outcome, knowing their loved ones already lost this battle.

Related Thursday Review articles:

Battles Over Military Spending; R. Alan Clanton; Thursday Review; February 25, 2014.